Elsevier

HPB

Volume 15, Issue 7, July 2013, Pages 504-510
HPB

Original Articles
Obesity portends increased morbidity and earlier recurrence following liver transplantation for hepatocellular carcinoma

https://doi.org/10.1111/j.1477-2574.2012.00602.xGet rights and content
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Abstract

Background

Obesity has been associated with poor oncologic outcomes following pancreatoduodenectomy for pancreatic cancer. However, there is a paucity of evidence on the impact of obesity on postoperative complications, oncologic outcome and survival in patients with hepatocellular carcinoma (HCC) undergoing orthotopic liver transplantation (OLT).

Methods

From a database of over 1000 patients who underwent OLT during 1996–2008, 159 patients with a diagnosis of HCC were identified. Demographic data, body mass index (BMI), perioperative parameters, recurrence and survival were obtained. Complications were grouped according to Clavien–Dindo grading (Grades I–V).

Results

There were increased incidences of life‐threatening complications in overweight (58%) and obese (70%) patients compared with the non‐obese patient group (41%) (P < 0.05). Furthermore, the incidence of recurrence of HCC was doubled in the presence of overweight (15%) and obesity (15%) compared with non‐obesity (7%) (P < 0.05). Time to recurrence also decreased significantly. Differences in mean ± standard deviation survival in the overweight (45 ± 3 months) and obese (41 ± 4 months) groups compared with the non‐obese group (58 ± 6 months) did not reach statistical significance.

Conclusions

These findings indicate that BMI is an important surrogate marker for obesity and portends an increased risk for complications and a poorer oncologic outcome following OLT for HCC.

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